Hey all - I have been reading the posts for a bit now and working towards a tight regulation glargine/lantus protocol with Moose. 14 year old black domestic short hair, polydactyl eating machine, lives in Canada.
Background - Moose was diagnosed about a year and a half ago - has been on Lantus BID with dosage ranging from 1.5-4 units. Aside from an initial scare with an overdose (now that he is all good it makes for a good story). For any newbies out there I would suggest that you never give anyone a dosage without a decimal and a zero. (i.e 2 I U instead of 2.0 I U.. in some handwriting/fonts 2 I looks a lot like 21 units not 2 International Units)...
For the record - 42 units of Lantus in 14 hrs is
Anyway - he made it - and got to fly in a plane for the first time! ohmygod_smile ...
For the past year he has been on 2.5 units for the most part. Slowly increasing from 1.5 - 2.0 - to 2.5. After that I was working away from town and had someone else feeding and dosing without a lot of testing). Now that I have been able to monitor much more closely - I have been populating his chart, and will be working on the tight protocol.
Current Situation - moose is on mini meals (every 4 hours) using Wellness Grain Free (turkey salmon, chicken formula, and beef chicken). They are timed so that he eats 1-2h prior to a pre-shot. I test, and give insulin, then monitor throughout the day when able.
He was sitting in the upper pinks typically for pre-shot values (20-25 mmol/L) and the nadir was still above 10 mmol/L almost always. With new Lantus in pen format (vs 10ml vial previously), I have been upping his dose.. and finally hit the green at 4 units... However with that dose - eating slowed.. and he was borderline hypo for the better part of two days (2.0 - 2.4). Compared to his earlier "hypo on a dextrose drip" this was a walk in the park with periodic kibble "pilled" to bump up as needed. He was behaviorally fine aside from reduced appetite.
I dropped to 2.0 units that night, and by the next morning he was back up to 7.6 (137), I bumped him back to 3.5 units to keep from losing the blue/green completely. Since then, he eats as much as I give him (~1/4 (5.5oz) can x 6 (1.5 cans) per day).. and is now back up to the 20-25 mmol (280-400) range at pre-shot with nadirs in the 15-17mmol/L range. Could be a case of new dose wonkyness.. or rebound, but the eating seems to have the most impact on his glucose. If he escapes (which he likes to do sometimes) and wont eat for the night - when he returns in the morning he will be looking great - and he will be in the yellow pre-shot... but back up to higher levels (flat curves) with food.
I should also mention that Moose has some signs of Acro/Cushings that may be a factor (huge appetite, loss of meow, odd breathing, twitchy) - but until his BG is regulated well, or I hit >5 units BID my main goal has been to get/keep the glucose down. The recent foray into the green at 4 units has me less worried about the Acro for now.. but I will have him tested if the dose goes up again.
So, aside from saying hello, and thanks to all who post here, I am curious if anyone has experience with food spikes/sustained high BG like this. I am tempted to try alternate foods - but the canned wellness grain free seemed to be one of the better choices (per Lisa Pierson's food guide @ 4% carb). My local vet has suggested Purina DM as an alternate... and with the salmon running in BC again - I will probably switch back to a mix of wellness canned with cooked/canned salmon as the first meal of the day when possible. I may also try the home made "raw food" (cat info.org recipe).
Link to Moose's Excel Chart
Thanks for reading.
Jason / Moose
Background - Moose was diagnosed about a year and a half ago - has been on Lantus BID with dosage ranging from 1.5-4 units. Aside from an initial scare with an overdose (now that he is all good it makes for a good story). For any newbies out there I would suggest that you never give anyone a dosage without a decimal and a zero. (i.e 2 I U instead of 2.0 I U.. in some handwriting/fonts 2 I looks a lot like 21 units not 2 International Units)...
For the record - 42 units of Lantus in 14 hrs is
- expensive in emergency treatment, in drug costs, in flights to see your sister the vet living across the country for treatment that you could not afford locally.
- Makes for very confused officials watching a cat get an IV implanted at the airport.
- Will give you a crash course in emergency hypo management (forget sneaking your iPhone out: try giving oral syrup on a plane without the flight attendant seeing you!), and
- makes for a very sad kitty.
Anyway - he made it - and got to fly in a plane for the first time! ohmygod_smile ...
For the past year he has been on 2.5 units for the most part. Slowly increasing from 1.5 - 2.0 - to 2.5. After that I was working away from town and had someone else feeding and dosing without a lot of testing). Now that I have been able to monitor much more closely - I have been populating his chart, and will be working on the tight protocol.
Current Situation - moose is on mini meals (every 4 hours) using Wellness Grain Free (turkey salmon, chicken formula, and beef chicken). They are timed so that he eats 1-2h prior to a pre-shot. I test, and give insulin, then monitor throughout the day when able.
He was sitting in the upper pinks typically for pre-shot values (20-25 mmol/L) and the nadir was still above 10 mmol/L almost always. With new Lantus in pen format (vs 10ml vial previously), I have been upping his dose.. and finally hit the green at 4 units... However with that dose - eating slowed.. and he was borderline hypo for the better part of two days (2.0 - 2.4). Compared to his earlier "hypo on a dextrose drip" this was a walk in the park with periodic kibble "pilled" to bump up as needed. He was behaviorally fine aside from reduced appetite.
I dropped to 2.0 units that night, and by the next morning he was back up to 7.6 (137), I bumped him back to 3.5 units to keep from losing the blue/green completely. Since then, he eats as much as I give him (~1/4 (5.5oz) can x 6 (1.5 cans) per day).. and is now back up to the 20-25 mmol (280-400) range at pre-shot with nadirs in the 15-17mmol/L range. Could be a case of new dose wonkyness.. or rebound, but the eating seems to have the most impact on his glucose. If he escapes (which he likes to do sometimes) and wont eat for the night - when he returns in the morning he will be looking great - and he will be in the yellow pre-shot... but back up to higher levels (flat curves) with food.
I should also mention that Moose has some signs of Acro/Cushings that may be a factor (huge appetite, loss of meow, odd breathing, twitchy) - but until his BG is regulated well, or I hit >5 units BID my main goal has been to get/keep the glucose down. The recent foray into the green at 4 units has me less worried about the Acro for now.. but I will have him tested if the dose goes up again.
So, aside from saying hello, and thanks to all who post here, I am curious if anyone has experience with food spikes/sustained high BG like this. I am tempted to try alternate foods - but the canned wellness grain free seemed to be one of the better choices (per Lisa Pierson's food guide @ 4% carb). My local vet has suggested Purina DM as an alternate... and with the salmon running in BC again - I will probably switch back to a mix of wellness canned with cooked/canned salmon as the first meal of the day when possible. I may also try the home made "raw food" (cat info.org recipe).
Link to Moose's Excel Chart
Thanks for reading.
Jason / Moose
